Examination feature | Potential significance |
Scoliosis examination | |
Lateral curvature of the spine | Scoliosis (any type) |
Asymmetry of shoulders, scapulae, waistline, or distance that the arms hang from the trunk | Scoliosis (any type) |
Thoracic or lumbar prominence during Adams forward bend test | Scoliosis (any type) |
Angle of trunk rotation (as measured with a scoliometer) ≥7° | Approximately correlates with Cobb angle of >20° |
General examination | |
Height and height velocity | Risk for progression is greatest during peak height velocity |
Arm span to height ratio | Increased in Marfan syndrome |
Sexual maturity rating (Tanner stage) | Risk for progression is increased if sexual maturity rating is ≤2 |
Skin examination | |
Café-au-lait spots and axillary freckling | Neurofibromatosis |
Vascular or pigmentary changes over the spine | Spinal dysraphism |
Lumbosacral dimpling | Occult spinal dysraphism |
Skin laxity | Ehlers-Danlos syndrome, Marfan syndrome, osteogenesis imperfecta |
Musculoskeletal examination | |
Joint laxity | Ehlers-Danlos syndrome, Marfan syndrome |
Intrinsic wasting of hands | Cervical syringomyelia |
High-arched feet, hammer/claw toes | Neuromuscular disease (eg, Friedreich ataxia) |
Asymmetric iliac crests | Leg length discrepancy |
Neurologic examination | |
Abnormal reflexes, balance, strength, gait | Neuromuscular scoliosis |
Absent abdominal reflex | Intraspinal pathology |
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